POMACY Registration

Dear Healthcare Professional,

We are delighted to welcome you to our platform! By registering here, you are taking the first step to join our community of dedicated healthcare professionals committed to delivering exceptional patient care and embracing digital healthcare innovation.

Why Register with Us?

1. Access to a Wide Range of Products: Explore an extensive selection of pharmaceuticals, medical devices, and healthcare essentials from reputable suppliers, all at your fingertips.
2. Convenience and Efficiency: Enjoy a seamless and efficient procurement experience with automated order management.
3. Competitive Pricing and Cost Savings: Benefit from competitive pricing and potential cost savings on your pharmaceutical purchases.
4. Stay Updated with Clinical Resources: Access a wealth of educational materials, clinical updates, and valuable resources to stay ahead in your practice.

Terms and Conditions:

Please take a moment to read and agree to our Terms and Conditions. Your registration signifies your acceptance of these terms.

Data Privacy:

We take your privacy seriously. The information you provide in this form will be handled in accordance with our Privacy Policy. Your data will only be used for the purpose of registration and to enhance our services.

Ready to Get Started?

Please fill out the required information in the form below, and we'll take care of the rest. If you have any questions or need assistance during the registration process, feel free to reach out to our dedicated support team at [email protected].

Thank you for choosing to join us on this exciting healthcare journey. We look forward to empowering you with the tools and resources you need to thrive in your profession!

Best regards,
TechMed Sdn Bhd

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Prefix Select Prefix Dr Mr Ms Other

Healthcare Professional Full Name

Specialty Select Specialty Allergy & Immunology Anesthesiology Cardiology Dental Dermatology Emergency Medicine Family Medicine General Practitioner General Surgery Hematology Internal Medicine Neurology Obstetrics & Gynecology Oncology Ophthalmology Orthopedic Otolaryngology Pathology Pediatrics Pharmacist Plastic Surgery Psychiatry Radiology Rheumatology Urology Veterinarian Other

Nature of Business Select Nature of Business Clinic - Private Clinic - Public Retail Pharmacy - Independent Retail Pharmacy - Chain Hospital - Private Hospital - Public Other

Business Registration Name

Company Name

Business Address

Address Line 1

Address Line 2

Postal Code

State Select State Perlis Kedah Penang Perak Kelantan Terengganu Pahang Kuala Lumpur Putrajaya Selangor Negeri Sembilan Melaka Johor Sabah Sarawak

Country

Mobile Number

Email Address

Delivery Address

Same as Business Address

Address Line 1

Address Line 2

Postal Code

State Select State Perlis Kedah Penang Perak Kelantan Terengganu Pahang Kuala Lumpur Putrajaya Selangor Negeri Sembilan Melaka Johor Sabah Sarawak

Country

Warehousing and Distribution (Account Code/Number: Sold to Code and Ship to Code)

Please provide the following information for us to do customer mapping and integration to the system.

Remark: Sold to code referring to 'bill to' and ship to code referring to 'deliver to'. If you do not have the specific account, please indicate 'NA'.

Zuellig Pharma Account Code (Sold to Code and Ship to Code)

DKSH Account Code (Sold to Code and Ship to Code)

Antah Pharma Account Code (Sold to Code and Ship to Code)

Practicing Certificate (Mandatory)

Designation Select Designation Doctor Pharmacist

SSM Form 9 / Form B

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Annual Practicing Certificate (APC)

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Annual Retention Certificate (ARC)

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Poison A License

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Add Subaccount User

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I agree to receive personalised commercial communications from POMACY via email and whatsapp messages.

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